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General NPI Number Information
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NPI Number | 1598200503
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Entity Type | Individual
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Provider Name | HAZEL VEGA HIROSHIMA NP
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Gender | Female
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Dates
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Enumeration Date | 12/29/2016
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Last Update Date | 08/08/2022
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Provider Practice Location Address
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Address Line | 400 TAYLOR BLVD STE 306
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City | PLEASANT HILL
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State | CA
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Zip | 94523-2160
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Country | US
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Telephone | 925-691-9688
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Fax |
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Provider Business Mailing Address
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Address Line | 400 TAYLOR BLVD
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City | PLEASANT HILL
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State | CA
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Zip | 94523-2147
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Country | US
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Telephone | 925-691-9688
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Fax | 510-985-2200
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 95005417
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95005417
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License Number State | CA
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